32 ms·

Less. I want a surgeon to have done my procedure a good number of times already recently (if I get to choose.)

Proziam 6y ago
I disagree. Pre-X checklists exist because the reliability gained by going through step-by-step isn't easily replicated by other means. And, even if the surgeon has done your procedure every day this week, what are the odds they did it for someone with exactly your 'specs'? Surely there are considerations to be made based on age, gender, allergies, fitness level, and much more that it would be worthwhile to address prior to cutting into the patient.
- dwighttk 6y ago
  Checklist, sure. Textbook, no.
barry-cotter 6y ago
That level of specialization doesn’t really exist in the US outside of the Oklahoma Surgery Center. Surgeons do a kind of surgery, not a particular surgery. That’s part of why some Indian surgical places are so good; much, much more specialization than is the norm in North America or Europe.
- refurb 6y ago
  In the US, it really depends on the surgery and the center. I know from chatting to some doctors that eye surgery for example, isn't exclusively cataract surgery, but it's like 60% of their surgeries and typically done by a handful of doctors. Back of the eye surgery is done at the same center, but by another set of doctors. So while it's true it's not common to find the type of single surgery centers like they have in India, there are lots of surgeons who do the same surgery weekly or several times per week. But yeah, if you're seeing an ENT at a smaller center, they might be doing 100 procedures a year and no more than 10 of any given type.
- s5300 6y ago
  Huh? This is completely wrong. For instance, I have Thoracic Outlet Syndrome. It's something really fucking shitty that overhead sports players and computer nerds are prone to (along with those with connective tissue disorders) It's surprisingly super fucking hard to get right and general surgeons have fucked a lot of people up attempting to do it. Most famously, a Houston Astros pitcher was left paralyzed by the surgery, and his surgeon later ran into him homeless under a bridge. I think I have that linked in my more recent of comments. Anyways, there are about 5 major hospitals in the U.S. with completely specialized Thoracic Outlet Surgery divisions within their vascular surgery wing of the hospital. These surgeons only do this one specific surgery - removing first/cervical ribs, sometimes along with two other involved muscles. My surgeon is Dr. Dean Donahue of Boston Mass General's Thoracic Outlet Surgery Program - arguably the most famous and successful practicioner of said surgery in the U.S./world. Now, obviously, my condition isn't some special case. There's quite a few 'rarer' super specific medical conditions requiring a single specific surgery that larger U.S. hospitals (think Mayo Clinic, Cedars Sinai, Mass General, Cleveland Clinic, etc) do have devoted wings for with surgeons that only do that singular procedure in their otherwise generalized division. Not just the "Oklahoma Surgery Center" Sorry if I misinterpreted what you were saying or if this otherwise seems like I'm ranting and rambling haha. Not trying to rant - just wanted to inform/give some insight.
GuB-42 6y ago
And yet pilots often read checklists, even after thousands of flight hours. In fact, they are often required to. It is a way to make sure they don't skip steps that are important in case of emergency. Emergencies don't happen often, and it is easy to forget them when things become routine. So it is understandable you want an experienced surgeon to do your procedure, but if a surgeon is reading a textbook, it doesn't mean he is less experienced than one who doesn't. He may be less confident, but if you consider the Dunning–Kruger effect, it is not necessarily a bad thing.
- dwighttk 6y ago
  A checklist is quite a bit different from a textbook

I disagree. Pre-X checklists exist because the reliability gained by going through step-by-step isn't easily replicated by other means. And, even if the surgeon has done your procedure every day this week, what are the odds they did it for someone with exactly your 'specs'? Surely there are considerations to be made based on age, gender, allergies, fitness level, and much more that it would be worthwhile to address prior to cutting into the patient.

dwighttk 6y ago
Checklist, sure. Textbook, no.

barry-cotter 6y ago

That level of specialization doesn’t really exist in the US outside of the Oklahoma Surgery Center. Surgeons do a kind of surgery, not a particular surgery. That’s part of why some Indian surgical places are so good; much, much more specialization than is the norm in North America or Europe.

refurb 6y ago
In the US, it really depends on the surgery and the center. I know from chatting to some doctors that eye surgery for example, isn't exclusively cataract surgery, but it's like 60% of their surgeries and typically done by a handful of doctors. Back of the eye surgery is done at the same center, but by another set of doctors. So while it's true it's not common to find the type of single surgery centers like they have in India, there are lots of surgeons who do the same surgery weekly or several times per week. But yeah, if you're seeing an ENT at a smaller center, they might be doing 100 procedures a year and no more than 10 of any given type.
s5300 6y ago
Huh? This is completely wrong. For instance, I have Thoracic Outlet Syndrome. It's something really fucking shitty that overhead sports players and computer nerds are prone to (along with those with connective tissue disorders) It's surprisingly super fucking hard to get right and general surgeons have fucked a lot of people up attempting to do it. Most famously, a Houston Astros pitcher was left paralyzed by the surgery, and his surgeon later ran into him homeless under a bridge. I think I have that linked in my more recent of comments. Anyways, there are about 5 major hospitals in the U.S. with completely specialized Thoracic Outlet Surgery divisions within their vascular surgery wing of the hospital. These surgeons only do this one specific surgery - removing first/cervical ribs, sometimes along with two other involved muscles. My surgeon is Dr. Dean Donahue of Boston Mass General's Thoracic Outlet Surgery Program - arguably the most famous and successful practicioner of said surgery in the U.S./world. Now, obviously, my condition isn't some special case. There's quite a few 'rarer' super specific medical conditions requiring a single specific surgery that larger U.S. hospitals (think Mayo Clinic, Cedars Sinai, Mass General, Cleveland Clinic, etc) do have devoted wings for with surgeons that only do that singular procedure in their otherwise generalized division. Not just the "Oklahoma Surgery Center" Sorry if I misinterpreted what you were saying or if this otherwise seems like I'm ranting and rambling haha. Not trying to rant - just wanted to inform/give some insight.

GuB-42 6y ago

And yet pilots often read checklists, even after thousands of flight hours. In fact, they are often required to. It is a way to make sure they don't skip steps that are important in case of emergency. Emergencies don't happen often, and it is easy to forget them when things become routine. So it is understandable you want an experienced surgeon to do your procedure, but if a surgeon is reading a textbook, it doesn't mean he is less experienced than one who doesn't. He may be less confident, but if you consider the Dunning–Kruger effect, it is not necessarily a bad thing.

dwighttk 6y ago
A checklist is quite a bit different from a textbook